| NPI | 1801644042 |
|---|---|
| Doing Business As | WISDOM TOOTH & DENTAL IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | JOSHUA ALLEN DEUEL Owner/Operator 269-845-0671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2024-05-13 |
| Last Update Date | 2024-05-13 |